JHC 2023 v7 i2 s7

Original Contribution

Histomorphological Pattern of Vocal Cord Lesions in a Tertiary Care Hospital

1.*Dr Naila Awal, Assistant Professor, Department of Pathology, Green Life Medical College, Dhaka.
nailaawal@gmail.com
2. Dr Md Saidur Rahman, Professor and Head, Department of Pathology, Sher-e-Bangla Medical College, Barishal.
3. Dr Subrata Ray, Assistant Professor, Department of Pathology, Sher-e-Bangla Medical College, Barishal.
4. Dr Abirvab Naha, Assistant Professor, Department of Otolaryngology- Head and neck Surgery, Bangabandhu
Sheikh Mujib Medical University, Dhaka.
5. Dr Rumana Yasmin, Assistant Professor, Department of Pathology, Dhaka Central International Medical College,
Dhaka.
6. Dr Lyzu Sharmin, Assistant Professor, Histopathology department, National Institute of Cancer Research and
Hospital, Dhaka.
7. Dr Md. Shafiqul Alam, Associate Professor, Radiology and Imaging Department, Monno Medical College,
Manikgonj.
*For correspondence

Abstract
Background: Voice is the most important component for human to communicate their ideas,
emotion and personality with the outside world. Vocal cord lesion is one of the most common
problems in the Otolaryngology Department. Even the smallest swelling on the free edge of vocal
cord can cause voice disturbances and has significant social and psychological impact. The aim of
our study was to find out the frequencies of the vocal cord lesions and to assess the various
histomorphological characteristics of these lesions among the patients of various age groups in
Bangladeshi population.
Methods: A retrospective, record review (secondary data analysis) study was carried out among
2054 patients who underwent surgery in Green Life hospital for any vocal cord lesion between the
period of 2011 to 2021. The data was collected from an electronic database from Histopathology
Department of Green Life Hospital.
Result: The study population consists of total 2054 cases with male and female ratio of 3.8:1. The
age of the patient was between 5 to 95 years and the majority of the patients (27%) were presented
with 3rd to 4th decades. Male (79%) were commonly affected than female (21%). Male patients
showed higher percentage in 40-50 years age group (21%), while female patient showed higher
percentage in 18-40 years age group (13%).
A total of 63 (3.1 %) cases were non neoplastic, 1966 (95.7%) cases were neoplastic, and 25 (1.2
%) cases were diagnosed as premalignant. The most common vocal cord lesion was vocal cord
polyp (81.3%) followed by invasive squamous cell carcinoma 272 cases (13.2%).
Conclusion: The histopathological examination of vocal cord lesion is the gold standard diagnostic
tool to evaluate voice disorders. The early diagnosis should be done carefully to evaluate
underlying pathology for better management

[Journal of Histopathology and Cytopathology, 2023 Jul; 7 (2):95-102]
Keywords: Vocal cord, Histopathology

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JHC 2023 July v7 i2 s6

Original Contribution
Use of Sentinel Lymph Node Biopsy to Detect Metastatic Spread in Axillary Nodes in Primary Breast Carcinoma

1.*Dr. SM. Basitur Roshid, Assistant Professor, Department of Pathology, BIRDEM, Dhaka,
dr.basitroshid@gmail.com
2. Professor Mohammed Kamal, Ex Chairman, Department of Pathology, BSMMU, Dhaka.
3. Dr. Mohammad Mahabubul Hoque, Assistant Professor of Pathology, National Institute of Laboratory Medicine
and Referral Centre, Agargaon, Dhaka. drshaikat331@gmail.com
4. Dr. Muhammad Ariful Haque, Assistant Professor, Faculty of Laboratory Medicine, ICMH, Matuail, Dhaka
*For correspondence

Abstract
Objectives: Although sentinel lymph node (SLN) biopsy is recommended approach in the evaluation
of metastatic status of lymph node in breast cancer management, the efficacy of this technique require
validation. In current study, results of patients who underwent sentinel lymph node biopsy by using
only methylene blue dye were evaluated.
Methods: The study included 17 cases of primary ductal carcinoma with tumor size up to 5.0cm.
Patients who had previous breast or axilla surgery and radiation or chemotherapy for any breast lesion
were excluded from this study. During operation 3.0 ml of sterilized methylene blue dye were
injected in peritumoral area or around the lumpectomy cavity. The axillary sentinel lymph node was
removed and later on axillary dissection was done. Imprint cytology, frozen section and routine H&E
slides were made from sentinel lymph node.
Results: The sentinel lymph node was found in all cases. Among them, eight (47.1%) cases were
positive for SLN and axillary lymph node and nine (52.9%) cases were negative for both SLN and
axillary lymph node. No false negative result was observed and no complication was recorded due to
use of methylene blue dye.
Conclusion: Sentinel lymph node biopsy is a safe and accurate method in staging the early breast
cancer. This method will reduce the unnecessary axillary lymph node dissection and other morbidity
associated with it

[Journal of Histopathology and Cytopathology, 2023 Jul; 7 (2):89-94]
Keywords: Breast cancer, Sentinel lymph node biopsy, Methylene blue dye

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JHC 2023 v7 i2 s5

Original Contribution

Morphological Patterns of Glomerular Diseases among Children Studied by
Light and Immunofluorescence Microscopy at Selected Tertiary Care Hospitals

1.*Dr. Muhammad Ariful Haque, Assistant Professor, Faculty of Laboratory Medicine, ICMH, Matuail, Dhaka.
ariful31st@gmail.com
2. Dr. Habiba Akter, Assistant Professor, Department of Physiology, Khwaja Yunus Ali Medical College, Sirajganj.
3. Dr. SM Basitur Roshid, Assistant Professor, Department of Pathology, BIRDEM, Dhaka.
4. Dr. Md. Shariful Haque, Deputy Program Manager-4, Hospital Services Management, DGHS, Dhaka.
5. Dr. Khaleda Khanom, Associate Professor, Faculty of Laboratory Medicine, ICMH, Matuail, Dhaka.
6. Dr. Shaikh Badiuzzaman, Assistant Professor, Department of Laboratory Medicine, BSMMU, Dhaka.
7. Dr. Mohammad Mahabubul Hoque, OSD, DGHS, Mohakhali, Dhaka.
*For correspondence

Abstract
Background: Glomerular disorders constitute one of the major causes of morbidity and mortality
in children and adult population. Diagnosing the pattern of glomerular diseases is important as the
treatment and outcome differs in different types. This study was undertaken to find out the various
morphological patterns of glomerular diseases among children at selected tertiary care hospital in
Bangladesh.
Methods: This cross-sectional study was carried out at the Department of Pathology, Bangabandhu
Sheikh Mujib Medical University (BSMMU), Dhaka from the period of September 2014 to June
2016. Renal biopsy samples of children with nephrotic syndrome and nephritic syndrome, children
having asymptomatic haematuria and isolated proteinuria and children presenting with acute and
chronic renal failure were included in this study. For routine histopathological examination, tissue
was preserved in 10% formalin. After completion of routine paraffin processing, hematoxylin and
eosin (H&E) and periodic acid Schiff (PAS) staining were done. For direct immunoflurescence
study, tissue was preserved in normal saline and processed according to standard protocol of
immunoflurescence study. Routine H&E and PAS stained sections of the renal biopsy samples
were examined for changes in glomeruli, tubules, interstitium and blood vessels. The site, pattern
and degree of antibody deposition in the renal tissue were observed by immunoflurescence study.
Final diagnosis was made by correlation of histopathological, immunofluorescence and clinical
findings.
Results: Mesangial proliferative glomerulonephritis (MesPGN) was the most common primary
glomerular disease diagnosed in patients followed by minimal change disease, IgA nephropathy,
membrano-proliferative glomerulonephritis and crescentic glomerulonephritis. Lupus nephritis was
the most common secondary glomerular disease diagnosed in patients.
Conclusion: The reported prevalence of different morphological patterns of glomerular diseases
among children in Bangladesh seems to be no definite pattern. In fact, the patterns vary according
to the geographical area, environment and racial background.

[Journal of Histopathology and Cytopathology, 2023 Jul; 7 (2):80-88]
Keywords: Glomerular diseases among children, Light and immunoflurescence microscopy, Tertiary care hospitals.

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JHC 2023 July v7 i2 s4

Original Contribution

Evaluation of Cyclin D1 Expression in Paediatric Common Solid Small
Round Cell Tumours

1.Dr. Md. Shahrior Nahid, MBBS, MD (Pathology), Medical Officer, Department of Pathology, National
Institute of Laboratory Medicine and Referral Centre (NILMRC), Dhaka-1207. shahrior.nahid@gmail.com
2. Prof. (Dr.) Ferdousy Begum, MBBS, MD (Pathology), Professor, Department of Pathology, Bangabandhu
Sheikh Mujib Medical University, Dhaka-1000.
3. Prof. (Dr.) Mohammed Shahed Ali Jinnah, MBBS, MD(Pathology), Professor, Department of Pathology,
National Institute of Laboratory Medicine and Referral Center, Sher-E-Bangla Nagar, Dhaka-1207.
4. Dr. Saumitra Chakravarty, MBBS, MD(Pathology), Assistant Professor, Department of Pathology,
Bangabandhu Sheikh Mujib Medical University, Dhaka-1000.
5. Dr. Arbin Siddiquea, MBBS, MD(Biochemistry), Lecturer, Department of Biochemistry, Shaheed
Suhrawardy Medical College, Dhaka-1207.
6. Dr. Abu Saeed Bin Hasem, MBBS, MD (Pathology), Lecturer, Department of Pathology, Sylhet MAG
Osmani Medical College.
7. Dr. Md. Shajjad Hossain, MBBS, MD(Pathology), Lecturer, Department of Pathology, Dhaka Dental
College, Dhaka.⃰
For correspondence

Abstract
Background: Small round blue cell tumors (SRBCTs) in children are a heterogeneous group of
neoplasms. Their diagnosis is very difficult due to their primitive character. Although the advent
of immunohistochemistry has improved the quality of diagnosis, some cases require molecular
analysis. However, the application of molecular tests is limited due to the lack of resources.
Nuclear expression of Cyclin D1 can be used as a diagnostic adjunct to conventional markers in
diagnosing small round cell tumors, especially when the diagnosis becomes difficult even
following the application of conventional markers.
Objectives: This study aimed to evaluate the immunoreactivity of Cyclin D1 in the common solid
small round blue cell tumors found in children below 15 years of age.
Methods: In this descriptive cross-sectional study, 64 confirmed (immunohistochemically and/or
morphologically) cases of SRBCTs including, Ewing sarcoma (31.25%), neuroblastoma (23.44%),
lymphoblastic lymphoma (21.87%), rhabdomyosarcoma (15.62%) and Wilms tumor (7.81%) in
children under 15 years were selected as samples by inclusion and exclusion criteria. Finally, the
immunoreactivity of Cyclin D1 in each case was assessed on the basis of staining pattern and
staining intensity.
Result: All cases of Ewing sarcoma and neuroblastoma exhibited nuclear expression for cyclin
D1. Seventy percent (14/20) of cases of Ewing sarcoma and 66.67% (10/15) of neuroblastoma
cases showed diffuse nuclear expression. Seventy percent (14/20) of cases of Ewing sarcoma and
93.33% (14/15) of neuroblastoma cases showed strong staining intensity (3+). In contrast, this
marker showed a negative reaction in rhabdomyosarcoma and lymphoblastic lymphoma, while it
was focally positive with moderate intensity in the blastemal component of 40% of cases of Wilms
tumor.
Conclusion: The present study suggests that cyclin D1 can be exploitable as a diagnostic adjunct
to conventional markers in confirming the diagnosis of Ewing sarcoma or Neuroblastoma.

[Journal of Histopathology and Cytopathology, 2023 Jul; 7 (2):69-79]
Keywords: Small round blue cell tumors (SRBCTs), Cyclin D1

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JHC 2023 July v7 i2 s3

Original Contribution

Histomorphological Patterns of Different Breast Lesions in a Tertiary Care Hospital

1. *Dr. Tanshina Afrin, MD (Pathology), Assistant Professor (C.C), Pathology Department, Rajshahi Medical
College. tanshinaafrin@gmail.com
2. Prof. Dr. S M Asafudullah, Professor and Head of Department of Pathology, Rajshahi Medical College
3. Dr. Khadiza Khanam, Professor, Pathology Department, Rajshahi Medical College.
4. Dr. Arefa Sultana, Associate Professor, Pathology Department, Rajshahi Medical College.
5. Dr. Anindita Sarkar, Assistant Professor (C.C), Pathology Department, Rajshahi Medical College.
6. Dr. Nazifa Islam, Assistant Professor (C.C), Pathology Department, Rajshahi Medical College.
7. Dr. Samrose Sultana, Assistant Professor (C.C) Pathology Department, Rajshahi Medical College.
* For correspondence

Abstract
Objective: Breast lesions are heterogeneous diseases that consist of several distinct entities
with remarkably different characteristic features. The present study was conducted to assess
histopathological findings of breast lesions in excision biopsy samples.
Methods: This cross-sectional study was conducted in the Department of Pathology, Rajshahi
Medical College over a period of one year from July 2021 to June 2022. A total of 105 cases of
breast lesions were included in this study.
Result: Out of 105 cases of breast lesions studied, 59 cases (72%) were malignant and 46 cases
were benign lesions. Fibroadenoma (18 cases out of 46) was the most common benign lesion
followed by breast abscess (9 cases out of 46). On the other hand, invasive ductal carcinoma
was the highest occurred malignant tumour (59 cases, 56%). The age range of breast lesion was
15 to 75 yrs and highest incidence was in between 31-50 years (both benign and malignant).
Most of the breast lesions were occurred in left breast (62%).
Conclusion: Histopathological examination plays an important role in differentiating between
benign and malignant lesions. In the present study the most common benign breast lesion was
fibroadenoma and the most common malignant lesion was infiltrating ductal carcinoma. The

[Journal of Histopathology and Cytopathology, 2023 Jul; 7 (2):62-68]
Keywords: Histopathology, Malignant, Benign lesions, Breast lesion

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JHC 2023 v7 i2 s2

Original Contribution

Ultrasound Guided Fine Needle Aspiration Cytology of Lung
Lesions

1. *Dr. Rukhshana Akhter Jahan, Associate Professor, Department of Pathology, Rajshahi Medical College,
Rajshahi. jahanrukhshana@gmail.com
2. Professor Dr. S M Asafudullah, Professor & Head, Department of Pathology, Rajshahi Medical College,
Rajshahi. drshamol@gmail.com
3. Dr. Rebeka Sultana, Consultant Pathologist, Raj Pathology, Rajshahi. doctorrebekasultana@gmail.com
4. Dr. S. M. Moshaddeq Hossain, Assistant Professor, Department of Pathology, Rajshahi Medical College,
Rajshahi. mridulrmcbd@yahoo.com
5. Dr. Samrose Sultana, Assistant Professor, Department of Pathology, Pabna Medical College, Pabna.
samrosesina@gmail.com

Abstract
Background: This study was aimed to evaluate the role of transthoracic ultrasound guided
FNAC in diagnosis of peripheral lung lesion. It is an important and useful investigation to
differentiate between benign and malignant lesions of lung. USG guided FNAC of lung lesion
is a safe, radiation free, and cost effective method. Besides, the procedure is simple and
complications if occur, can be managed conservatively.
Methods: This was a cross-sectional study conducted at the department of Pathology,
Rajshahi Medical College. Some samples were also collected from a private diagnostic centre,
Rajshahi over a period of one year from January 2021 to December 2021. 150 patients who
fulfilled inclusion criteria were included in this study. After properly explaining the procedure
and taking informed consent, USG guided FNAC was done in all the patients. Radiological
and cytological data of enrolled patients was collected prospectively and analyzed.
Results: Among the 150 patients, this study comprising of 120 male and 30 female in age
range of 21 to 90 years. Malignancy was the most common cytological diagnosis (76%) while
as benign diagnosis was reached in 22.66%. In 1.33% of patients, FNAC was inconclusive.
Squamous cell carcinoma was the most common malignancy diagnosed in 46(30.66%)
patients, followed by adonocarcinoma 31(20.66%), 19(12.66%) patients had undifferentiated
carcinoma, metastatic carcinoma 09(06%), small cell carcinoma 07(4.66%), and Non Hodgkin
lymphoma was diagnosed in 02(1.33%) patients. Among the benign group, nonspecific
chronic inflammation was diagnosed in 18(18%) patients, tuberculous granuloma 07(4.66%),
while the smear was inconclusive in 02(1.33%) patients.
Conclusion: Ultrasound guided fine needle aspiration cytology is safe, less expensive, less
time consuming, less invasive diagnostic tool with high degree of accuracy and no radiation
toxicity to lung lesions

[Journal of Histopathology and Cytopathology, 2023 Jul; 7 (2):55-61]
Keywords: Malignancy, Tuberculosis, USG guided Fine needle aspiration cytology.

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JHC 2023 July v7 i2 s1

Editorial

Challenges and Prospects of Establishing a Genome Sequencing Laboratory in Bangladesh

Dr. DM Arifur Rahman
Associate Professor (Histopathology), TMSS Medical College, Bogura. arifurrahmandm@gmail.com
Abstract: Not available
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JHC 2023 July v7 i1 s2

Original Contribution

Immunohistochemical Evaluation of Ki67 Expression in Premalignant and Malignant Esophageal Lesions – Study of 54 Cases in a Tertiary Care Hospita

1. *Dr. Shifayat Sultana, Assistant Professor, Department of Pathology, Central Medical College, Cumilla.
shifayat.sultana.ss@gmail.com
2. Dr. Syeda Sadia Afrin, Lecturer, Department of Pathology, Dhaka Medical College, Dhaka.
3. Dr. Zubaida Bahroon Khan, Associate Professor, Department of Pathology, Dhaka Medical College, Dhaka.
4. Dr. Shirin Gull Zabin, Assistant Professor, Department of Pathology, Dhaka Medical College, Dhaka.
5. Dr. Rumana Afrin Sweety, Assistant Professor, Department of Pathology, Marks Medical College, Dhaka.
6. Dr. Md. Ariful Islam, Assistant Professor, Department of Pathology, Monowara Sikder Medical College,
Shariatpur.
7. Dr. Nazma Shaheen, Assistant Professor, Department of Pathology, Gonoshasthaya Samaj Vittik Medical College,
Dhaka.
8. Dr. Fatima Tuj Jahra, Assistant Professor, Department of Pathology, Aichi Medical College, Dhaka.
9. Professor Dr. Ruksana Jeba, Professor and Head, Department of Pathology, Dhaka Medical College, Dhaka.
10. Professor Dr. Rezaul Karim Dewan, Professor and Head, Department of Pathology, Greenlife Medical College,
Dhaka.
*For correspondence

Abstract
Background: In Bangladesh esophageal carcinoma is the leading malignant condition. Mortality
rate of esophageal cancer is very high. Like other malignancies, early detection offers the best
prognosis for esophageal carcinoma. Regular endoscopic and histologic surveillance have become
standard procedure for follow up of patients with premalignant lesions. But sometimes
histomorphological diagnosis on routine biopsies can be challenging for pathologist. Several
studies showed that positive Ki67 expression is significantly associated with higher grade of
esophageal lesions and is a potential prognostic marker.
Objectives: The aim of the present study was to evaluate Ki67 expression in each
histopathological category and to investigate the relationship of Ki67 with premalignant and
malignant esophageal lesions.
Methods: This study was a cross sectional study, carried out at the department of Pathology in
Dhaka Medical College and Hospital from March 2018 to February 2020. Total 54 cases of
esophageal biopsy were included in this study. They were divided in maligant and premalignant
category. All obtained samples were selected for routine histopathological study and
immunostaining for Ki67 was done in formalin fixed paraffin embedded tissue.
Results: Most of the patients were male and mean age was 55.04 (±15.48) years. Squamous cell
carcinoma was the most common malignancy seen in (26 cases) 48.15 % of patients and Barrett’s
esophagus was common (13 cases, 24.07%) premalignant lesion. Ki67 expression was found
statistically significant (p<0.05) when correlated with histomorphologic grading of premalignant
and malignant lesions. Calculation result of malignant and premalignant category as a whole
should be stated.
Conclusion: Ki67 expression positively correlates with histomorphologic grading of premalignant
and malignant esophageal lesions.

[Journal of Histopathology and Cytopathology, 2023 Jan; 7 (1):3-11]
Keywords: Barrett’s esophagus, esophageal carcinoma, Ki67

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JHC 2023 July v7 i1 s1

Editorial

PD-L1 Expression in Colon Carcinoma: A Promising Target for Immunotherapy

Dr Shamim Akhter Mimi
Professor and Head of the Department of Pathology, Sylhet MAG Osmani Medical College, Sylhet. shamimakhtermimi@gmail.com

Abstract: Not Available

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jhc.2024.8.1.09

Journal of Histopathology and Cytopathology

January 2024 Volume 8 Issue 1


Case Report

Swyer Syndrome with Gonadoblastoma: A Case Report

1. *Dr. Tasnim Binte Ahmed, Histopathologist, Department of Pathology, Mugda Medical College, Dhaka. ahmedtussy@gmail.com
2. Dr. Muhammad Enamul Haque, Senior Consultant, Department of Gynae & Obstetrics. Sir Salimullah Medical College, Dhaka. 3. Dr. Naila Huq, Professor & Head, Department of Pathology,Mugda Medical College, Dhaka.
*For correspondence

Abstract 
Background: Swyer syndrome is a condition of pure gonadal dysgenesis with 46, XY karyotype. These patients have female external phenotype and usually presented with primary amenorrhea. Detailed history, clinical, radiological and hormonal evaluation, karyotyping and histopathology are needed for diagnosis. Due to the presence of Y chromosomes these patients have streak gonads with increased risk of development of gonadoblastoma. Early diagnosis of Swyer syndrome followed by prophylactic gonadectomy is very important.
Case presentation: A 19-year-old female presented with the complaints of primary amenorrhea. The clinical, radiological, hormonal assessment and karyotyping test made the diagnosis of Swyer syndrome. The histopathological examination revealed left sided streak gonad and right sided gonadoblastoma.
Conclusion: Swyer syndrome is a rare form of disorders of sexual development. As there is high chance of gonadal malignancy, these patients should be counseled for preventive bilateral salpingo-oophorectomy

[Journal of Histopathology and Cytopathology, 2024 Jan; 8 (1):65-68]

Keywords: Swyer syndrome, Gonadal dysgenesis, Gonadoblastoma.

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